NPI | 1033166277 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208600000X Surgery (Licence: FL ME121156) |
Additional Taxonomies | 208600000X Surgery (Licence: MA 219190) |
208600000X Surgery (Licence: OH 90162) | |
Enumeration Date | 2006-05-30 |
Last Update Date | 2021-12-06 |